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Marc Le Rhun

Publications and source records attributed to Marc Le Rhun.

6 recordsLinked to original sources
PubMed2006

Rabeprazole test for the diagnosis of gastro-oesophageal reflux disease: results of a study in a primary care setting.

AIM: To determine the diagnostic value of the rabeprazole test in patients seen by general practitioners. METHODS: Eighty-three patients with symptoms suggestive of GERD were enrolled by general practitioners in this multi-centre, randomized and double-blind study. All patients received either rabeprazole (20 mg bid) or a placebo for one week. The diagnosis of GERD was established on the presence of mucosal breaks at endoscopy and/or an abnormal esophageal 24-h pH test. The test was considered to be positive if patients reported at least a "clear improvement" of symptoms on a 7-point Likert scale. RESULTS: The sensitivities of the test for rabeprazole and the placebo were 83% and 40%, respectively. The corresponding specificity, positive and negative predictive values were 45% and 67%, 71% and 71%, and 62% and 35%, respectively. A receiver operating characteristics (ROC) analysis confirmed that the best discriminatory cut-off corresponded to description of "clear improvement". CONCLUSION: The poor specificity of the proton-pump inhibitor (PPI) test does not support such an approach to establish a diagnosis of GERD in a primary care setting.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2006

High resolution colonoscopy with chromoscopy versus standard colonoscopy for the detection of colonic neoplasia: a randomized study.

BACKGROUND & AIMS: High-resolution colonoscopy with chromoscopy (HRC) is a technique designed to improve the detection of colonic neoplasias. We prospectively compared standard colonoscopy (SC) and HRC in a randomized multicenter trial. METHODS: Patients (n = 203; age, 58 +/- 10 years; sex ratio, 1) were recruited according to the following criteria: (1) a history of either familial or personal colonic neoplasia or (2) alarm symptoms after the age of 60 years. After randomization, an SC was performed in 100 patients (resolution, < or = 410,000 pixels) and a HRC in 103 patients (Fujinon EC485ZW, 850,000 pixels). In the HRC group, each colonic segment was examined before and after spraying with indigo carmine 0.4%. RESULTS: Two hundred seventy-six polyps were detected in 198 patients. One hundred sixty of them were hyperplastic polyps, 116 were adenomas, and 2 were carcinomas. The numbers of hyperplastic polyps and purely flat adenomas were significantly higher in the HRC group than in the SC group (1.1 +/- 1.6 vs 0.5 +/- 1.4 and 0.22 +/- 0.68 vs 0.07 +/- 0.29, respectively; P = .01 and P = .04), but there was no significant difference in the total number of adenomas per patient (primary end point) detected between the HRC and the SC groups (0.6 +/- 1.0 vs 0.5 +/- 0.9, respectively). CONCLUSIONS: Although HRC improves detection of purely flat adenomas and hyperplastic polyps, the overall detection of colonic adenomas in a population at increased risk of neoplasia is not significantly improved. These findings do not support the routine use of HRC in clinical practice.

Adenoma↗
PubMed2005

[Rectal Abrikossof tumor: a rare location].

Granular cell tumors or Abrikossof tumors are neurogenous ubiquitary submucosal-like tumors that are usually benign. The most frequent locations are the skin and buccal cavity. The usual location in the digestive tract is the esophageal wall. We report a rare case of Abrikossof tumor of the rectum that was not operated on because of a certain diagnosis and a low risk of malignancy.

Adult↗
PubMed2004

Push enteroscopy for gastrointestinal bleeding: diagnostic yield and long-term follow-up.

AIM: Little is known about the long-term course of patients explored by push enteroscopy for gastrointestinal bleeding of obscure origin. This study aimed to determine the diagnostic yield and the therapeutic impact of enteroscopy, the rate of rebleeding and predictive factors of rebleeding in these patients. PATIENTS AND METHODS: One hundred nineteen patients underwent push enteroscopy for overt bleeding (N=66) or anemia (N=53). RESULTS: Enteroscopy was positive in 42% of patients (colon 17%, stomach 13%, small bowel 12%) and diagnosed arteriovenous malformations in two-thirds of patients. Twenty-five additional diagnoses were established during the 2-month follow-up. Treatment was definitive in 13% of patients, without recurrent bleeding. Rebleeding occurred in 45% of patients, and was more frequent when a lesion was visualized (73% vs 28% after 5 years, P=0.02). In multivariate analysis, a lesion visualized by enteroscopy was the only independent predictive factor. CONCLUSION: Enteroscopy is not a high-performance diagnostic tool for obscure gastrointestinal bleeding and enables definitive treatment in less than 15% of patients.

Adolescent↗
PubMedDate not supplied

[Evaluation of endoscopic diagnosis of Barrett's esophagus based on analysis of 346 reports].

OBJECTIVES: To evaluate the different endoscopic ways of diagnosing Barrett's esophagus (BE) and assess the quality of BE endoscopic reports using a rating grid. MATERIAL AND METHODS: Three-hundred and forty-six reports concerning BE (1997-2000) were divided into two groups, circular and non-circular BE, and rated on a scale (0 to 20 points) by two readers using a grid to evaluate, in particular, the description of BE, hiatal hernia and esophagitis and biopsy practice. RESULTS: The score was >=10 points for 129 reports (37.3%). Points were deducted because of inadequate description of BE and hiatal hernia and particularly for a lack of biopsies (54% of reports). The indication of endoscopy (BE monitoring) and the form of medical arrangements (out- or in patients) had a significant effect on the mean score of the reports. Circular BE (46.5% of all reports) was described with respect to the height of the squamo-columnar junction (Z line) and the length of BE, and non-circular BE (40.4% of all reports) with respect to the number and height of the strips. Hiatal hernia, if detected, was described (67.2%) by its length, and esophagitis by standard classifications (70.1%). Finally, biopsy practice differed significantly as a function of the indication, the experience and status of the operator, or the medical management of the patient. CONCLUSION: This study showed that the endoscopic reports of BE are not sufficiently rigorous and that the absence of biopsies is frequently not justified. In the future, standardized reports could be proposed by working groups of experts and then prospectively tested and approved.

Adult↗